Ismael-Mohammed Kovan, Bolivar-Prados Mireia, Laguna Laura, Nuñez Lara Adrian, Cera Marta, Viñas Paula, Clavé Pere
Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Barcelona, Spain.
Institute of Agrochemistry and Food Technology (IATA, CSIC), 46980 Valencia, Spain.
Foods. 2025 May 13;14(10):1723. doi: 10.3390/foods14101723.
The optimal textural properties and therapeutic effects of fork-Mashable dishes for hospitalized older patients with oropharyngeal dysphagia (OD) have not been adequately defined.
This study aimed to (a) quantify the textural properties of six fork-Mashable dishes (British Dietetic Association (BDA) texture E; International Dysphagia Diet Standardization Initiative (IDDSI) level 6), (b) assess the impact of oral processing on texture, and (c) evaluate their safety and efficacy in older patients with OD.
Twenty patients (85 ± 4.51 years) consumed six 30 g dishes. Oral processing was analyzed using surface electromyography (EMG), texture was measured pre- and post-oral processing, and swallowing safety was assessed using the volume-viscosity swallowing test (V-VST).
Although all the dishes met the BDA E/IDDSI 6 descriptors, significant differences were found in both safety (ranging from 50-100%, < 0.05, for four dishes vs. thin liquids) and efficacy outcomes (oral residues 60-100%; pharyngeal residues 20-70%; < 0.05 for all dishes vs. liquids and French and zucchini omelets vs. 250 mPa·s). Textural characteristics showed wide variability. Oral processing reduced MF but increased adhesiveness, except for in French omelet and pollock fish. The patients required 29-31 mastication cycles over 21-28 s. The post-oral texture also varied significantly across dishes.
The therapeutic effect of our diets was independent of the BDA or IDDSI levels, with great variations in safety and swallowing efficacy. Textural properties, oral processing behavior, and individual patient responses played decisive roles. Variations in maximum force and adhesiveness during oral processing were crucial for the therapeutic effect, as indicated by the principal component analysis (PCA) correlation.
对于患有口咽吞咽困难（OD）的住院老年患者而言，叉可捣碎菜肴的最佳质地特性和治疗效果尚未得到充分界定。
本研究旨在（a）量化六种叉可捣碎菜肴（英国饮食协会（BDA）质地E级；国际吞咽困难饮食标准化倡议（IDDSI）6级）的质地特性，（b）评估口腔加工对质地的影响，以及（c）评估它们对患有OD的老年患者的安全性和疗效。
20名患者（85±4.51岁）食用了六种30克的菜肴。使用表面肌电图（EMG）分析口腔加工过程，在口腔加工前后测量质地，并使用体积 - 粘度吞咽测试（V - VST）评估吞咽安全性。
尽管所有菜肴均符合BDA E/IDDSI 6的描述，但在安全性（四种菜肴与稀液体相比，范围为50 - 100%，<0.05）和疗效结果（口腔残留60 - 100%；咽部残留20 - 70%；所有菜肴与液体、法式煎蛋卷和西葫芦煎蛋卷相比，<0.05，与250 mPa·s相比）方面均发现了显著差异。质地特征显示出很大的变异性。除了法式煎蛋卷和狭鳕鱼外，口腔加工降低了硬度但增加了粘性。患者在21 - 28秒内需要29 - 31次咀嚼循环。口腔加工后的质地在不同菜肴之间也有显著差异。
我们的饮食治疗效果与BDA或IDDSI水平无关，在安全性和吞咽疗效方面存在很大差异。质地特性、口腔加工行为和个体患者反应起决定性作用。如主成分分析（PCA）相关性所示，口腔加工过程中最大力和粘性的变化对治疗效果至关重要。
